Cardiovascular disease

Heart Disease

Cholesterol and CVD

Reducing the proportion of fat in your diet, especially saturated fat, can help to reduce blood cholesterol levels. There’s a strong link between high blood cholesterol levels and the risk of heart disease. For those who don’t have CVD or aren’t considered to be at high-risk of CVD, normal blood cholesterol levels are below 5mmol/litre. This can be measured by your GP. People with average energy needs should aim to consume no more than 70g/day of fat and less than 20g/day of saturated fat.

Trans-fatty acids are a particular kind of fat that are naturally occurring in meat and dairy products but may also be produced when plant-based oils are hydrogenated to produce solid spreads, such as margarines. They’re often found in confectionery and processed food like pastry, biscuits and cakes. They’ve been found to have the same effect on cholesterol levels as saturated fat and should be avoided as much as possible. Thankfully, many manufacturers have now modified processing techniques to keep these fats to a minimum. Check labels for hydrogenated fats.

When reducing total fat, it’s important not to cut out the heart healthy fats from your diet including mono and poly-unsaturated fats and omega-3, mostly found in plant and fish oils.

How to modify your fat intake:

  • Use butter and other spreads sparingly
  • Choose lean cuts of meat or trim fat off
  • Grill, bake or steam food rather than frying
  • Swap saturated fats such as butter for unsaturated oils such as sunflower, rapeseed or olive oil
  • Limit your intake of trans-fats from processed food
  • Eat two to three portions of oily fish each week (e.g. sardines, mackerel, fresh tuna, salmon)

Essential fatty acids

Essential fatty acids such as omega-3s, which are found in oily fish, have been shown to reduce the risk of CVD by lowering blood triglycerides, reducing blood clotting and regulating heart rhythm. For general heart health, try to eat two portions of fish per week, one of which should be oily.

Stanols and sterols

Certain plant-derived compounds, called stanol or sterol esters have been shown to reduce cholesterol levels. Spreads, yoghurts, drinks and soya ‘dairy alternatives’ are now available containing these products. These sterol enriched foods may be particularly useful for those with raised blood cholesterol which has remained elevated even after making other dietary changes. Clinical trials show that when used regularly, they can reduce high cholesterol levels.

Fruit and vegetables

Fruit and vegetables are rich in many essential nutrients including vitamins C and E and carotenoids (which are all antioxidants). They may help to protect the heart by limiting the damaging effects of cholesterol on body tissues. Aim for at least five servings of fruit and vegetables a day. (See the Fruit and Vegetables article for more information on what a serving is.)

Wholegrains and fibre

Studies of large groups of people in the US have shown that diets rich in wholegrain food can reduce the risk of CVD by up to 30 per cent. You can include wholegrain food in every meal by choosing wholemeal bread and wholegrain varieties of pasta and rice.

Soluble dietary fibre, found in oats, beans and pulses, can help to lower LDL cholesterol. These foods should be included as part of an overall healthy balanced diet, at least two to three times each week.

Soya protein

A diet that includes at least 25g of soya per day has been associated with reductions in LDL cholesterol and CVD. Soya isoflavones in particular have been shown to reduce CVD risk as they inhibit the growth of cells that form artery-clogging plaque. Soya protein is also an excellent substitute for meat and is available in a convenient and tasty form in many ready-made meals. Another good source of soya protein is soya milk and yoghurt.

The British Heart Foundation has an excellent range of resources giving information about reducing your risk of cardiovascular disease.

Rest and relaxation

While exercise can help lower blood pressure and strengthen your heart, rest and relaxation can reduce your levels of anxiety and improve your reactions to stress – both of which can affect the blood vessels and heart. All of us have to contend with major life events from time to time such as a divorce, bereavement, job loss or financial problems. However, there’s also a wide range of everyday events (being stuck in traffic, a row with your partner or a disagreement with someone at work) that can be stressful – and these everyday irritations may be even more stressful because they are constant.

Ways to manage stress

  • Keep a diary: make a note of stressful situations and how your react to them. This will help you identify what stresses you out, so you can begin to change your reactions.
  • Stay positive: your thoughts control your feelings. If you stop and listen to your emotions, you may be surprised to discover how negative they are. Replacing negative thoughts with positive ones will help you deal with stressful situations more calmly.
  • Learn to relax: pay attention to your posture and consciously relax physically. You may also want to try a technique such as yoga, massage, meditation or other complementary therapies.
  • Get as much sleep as you need: we all need different amounts of sleep and you will know how many you need to feel refreshed. Try to get this amount of sleep most nights.

Smoking and alcohol

Smoking and drinking are both linked with heart disease. But while there are no potential health benefits from smoking, moderate drinking can help to protect your heart.

Smoking

One of the most important things you can do to reduce your risk of heart disease is to stop smoking. Smokers younger than 50 are five times more likely than non-smokers to die of coronary heart disease. By stopping, you not only lower your risk of heart disease but also help reduce your risk of lung diseases such as cancer and chronic obstructive pulmonary disease (COPD). The key to successful quitting is to pick a method that’s right for you. For example, if you’re motivated by other people and enjoy their company, you may find encouragement and support by joining a group.

If you prefer to go it alone, you may find it helpful to buy a book or tape. Your GP can prescribe aids such as nicotine replacement therapy or, alternatively, you may benefit from a complementary therapy such as acupuncture.

Drinking alcohol

Consuming moderate amounts of alcohol – between one and two units a day – has been found to reduce the risk of CVD. Alcohol can increase HDL cholesterol and makes it less likely that clots will form. However, high intakes of alcohol are associated with increased risk. It’s also worth noting that saving up your weekly units for a weekend binge doesn’t offer the same benefits.

There’s no need to give up alcohol altogether but it’s important to drink sensibly.

Always eat when you drink: take a tip from the Mediterranean countries and always have a meal or snack when you drink alcohol. Know your limits: To reduce the risk of coronary heart disease, don’t exceed 1-2 units of alcohol a day. A unit is equal to half a pint of regular strength beer or lager, one small glass of wine or a small (pub measure) of spirits. Watch your glass size: it’s easy to exceed safe limits by using a bigger glass.

Mix and match: if you’re at a party or drinking socially, try to have a non-alcoholic drink for every alcoholic drink you consume. Once you’ve consumed your daily units, drink only soft or non-alcoholic drinks.

Regular monitoring

People should also have regular blood pressure readings, height and weight monitoring, and tests for cholesterol levels. Those with high levels should be encouraged to improve their diet and can be treated for poor cholesterol levels with drugs – usually, statins or niacins.

The American Heart Association recommends that blood pressure should be no more than 140 over 90 Hg. The association recommends a series of diets, with no more than 30% of calories coming in the form of fats, and limiting calories in the form of saturated fats to between 7 and 10%.

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Cardiac Rehabilitation

Heart Disease

WHAT ARE THE GOALS OF CARDIAC REHABILITATION?

The overall goals of cardiac rehab are to help you:

  • Recover after a heart attack or heart surgery.
  • Address risk factors that lead to coronary artery disease and other heart problems. These risk factors include high blood pressure, high blood cholesterol, overweight or obesity, diabetes, smoking, lack of physical activity, and depression and other emotional health concerns.
  • Adopt healthy lifestyle changes.
  • Improve your health and quality of life.

The rehab team will work with you to reach these goals. You will do this through increased daily physical activity, following a heart healthy eating plan, quitting smoking, and improving your emotional health.

INCREASED DAILY PHYSICAL ACTIVITY

Physical activity lowers your risk for heart problems, such as a heart attack. It helps reduce LDL (“bad”) cholesterol and increase HDL (“good”) cholesterol. It also helps control your blood pressure and blood sugar level.

Physical activity will help you improve muscle strength, flexibility, and endurance. It can help you lose weight, which can lower your risk for heart disease. Physical activity also helps you cope better with stress, and it may boost your sense of well-being.

Exercise training as part of cardiac rehab may not be safe for all patients. For example, people who have very high blood pressure or severe heart disease may not be ready for exercise training. These patients can still benefit from other parts of the cardiac rehab program.

FOLLOWING A HEART HEALTHY EATING PLAN

Improving your diet will help you control your cholesterol, blood pressure, and blood sugar. It also may help you lose weight if you’re overweight or obese, which is an important step for lowering heart disease risk.

The dietitian on your cardiac rehab team will help you create a personal eating plan.

QUITTING SMOKING

Quitting smoking will help you control cholesterol and blood pressure and lower your risk for heart problems. It also will make it easier for you to take part in physical activities.

IMPROVING YOUR EMOTIONAL HEALTH

Learning how to manage stress, relax, cope with problems, and build a social support network can improve your emotional as well as your physical health.

Some communities have support groups for people who have had a heart attack or heart surgery. They also may have walking groups or exercise classes.

Physical activity helps some people cope with stress. Other people reduce stress by listening to music or learning to focus on something calm or peaceful. Some people learn yoga, tai chi, or how to meditate.

There are many different types of “relaxation techniques” (ways to relax). By learning to relax and cope with stress, you can reduce your anxiety and lower your blood pressure, heart rate, and cholesterol.

This is true even if you don’t reduce other risk factors. Improving your emotional health can decrease your risk of death and future heart problems. It also can increase the chance that you will quit smoking and adopt other healthy behaviors.

Your rehab program also may offer individual or small group counseling to help you.

Cardiac Rehabilitation

Heart Disease

WHAT ARE THE GOALS OF CARDIAC REHABILITATION?

The overall goals of cardiac rehab are to help you:

  • Recover after a heart attack or heart surgery.
  • Address risk factors that lead to coronary artery disease and other heart problems. These risk factors include high blood pressure, high blood cholesterol, overweight or obesity, diabetes, smoking, lack of physical activity, and depression and other emotional health concerns.
  • Adopt healthy lifestyle changes.
  • Improve your health and quality of life.

The rehab team will work with you to reach these goals. You will do this through increased daily physical activity, following a heart healthy eating plan, quitting smoking, and improving your emotional health.

Life After a Heart Attack

Heart Disease

Many people survive heart attacks and live active, full lives. If you get help quickly, treatment can limit damage to your heart muscle. Less heart damage improves your chances for a better quality of life after a heart attack.

Medical Followup

After a heart attack, you’ll need treatment for coronary heart disease (CHD). This will help prevent another heart attack. Your doctor may recommend:

  • Lifestyle changes, such as following a healthy diet, being physically active, maintaining a healthy weight, and quitting smoking
  • Medicines to control chest pain or discomfort, high blood cholesterol, high blood pressure, and your heart’s workload
  • A cardiac rehabilitation program

If you find it hard to get your medicines or take them, talk with your doctor. Don’t stop taking medicines that can help you prevent another heart attack.

Returning to Normal Activities

After a heart attack, most people who don’t have chest pain or discomfort or other problems can safely return to most of their normal activities within a few weeks. Most can begin walking right away.

Sexual activity also can begin within a few weeks for most patients. Talk with your doctor about a safe schedule for returning to your normal routine.

If allowed by State law, driving usually can begin within a week for most patients who don’t have chest pain or discomfort or other problems. Each State has rules about driving a motor vehicle following a serious illness. People who have complications shouldn’t drive until their symptoms have been stable for a few weeks.

Anxiety and Depression After a Heart Attack

After a heart attack, many people worry about having another heart attack. Sometimes they feel depressed and have trouble adjusting to new lifestyle changes.

Talk about how you feel with your health care team. Talking to a professional counselor also can help. If you’re very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life.

Joining a patient support group may help you adjust to life after a heart attack. You can see how other people who have the same symptoms have coped with them. Talk with your doctor about local support groups or check with an area medical center.

Support from family and friends also can help relieve stress and anxiety. Let your loved ones know how you feel and what they can do to help you.

Risk of a Repeat Heart Attack

Once you’ve had a heart attack, you’re at higher risk for another one. Knowing the difference between angina and a heart attack is important. Angina is chest pain that occurs in people who have CHD.

The pain from angina usually occurs after physical exertion and goes away in a few minutes when you rest or take medicine as directed.

The pain from a heart attack usually is more severe than the pain from angina. Heart attack pain doesn’t go away when you rest or take medicine.

If you don’t know whether your chest pain is angina or a heart attack, call 9–1–1.

The symptoms of a second heart attack may not be the same as those of a first heart attack. Don’t take a chance if you’re in doubt. Always call 9–1–1 right away if you or someone else has heart attack symptoms.

Unfortunately, most heart attack victims wait 2 hours or more after their symptoms start before they seek medical help. This delay can result in lasting heart damage or death.

Risk Factors Of Ischemic Heart Disease

Heart Disease

Ischemic Heart Disease we can include people with personal or family history of:
heart attack (myocardial infarction)-when a part of heart muscle is permanently damaged or actually dies because there’s not enough oxygen.
unstable angina-is an intermediary between myocardial infarction and stable angina.It’s manifestation is a severe chest pain that lasts more than stable angina and it doesn’t respond very well to medication.
angina-is a chest discomfort which occurs when the coronary vessels receive an inadequate blood flow.
atherosclerosis-occurs when fatty material deposite into the arteries walls. This can lead to a blockage of the arteries.
Other risk factors for Ischemic Heart Disease are:
hypertension (high blood pressure)- blood pressure can vary with activity and with age, but a healthy adult who is resting generally has a systolic pressure reading between 120 and 130 and a diastolic pressure reading between 80 and 90 (or below).
diabetes-heart problems are the leading cause of death among people with diabetes, especially in the case of non-insulin-dependent diabetes also known as Type II diabetes.
high blood cholesterol-cholesterol is a fat-like substance carried in your blood.It can be found in all of your body’s cells. The liver produces all of the cholesterol your body needs to form cell membranes and to make certain hormones. Extra cholesterol enters your body when you eat foods that come from animals (meats, eggs,and other similar products).
obesity and overweight- extra weight leads to increased total cholesterol levels, high blood pressure, and an increased risk of coronary artery disease. Obesity increases your chances of developing other risk factors for heart disease, especially high blood pressure, high blood cholesterol, and diabetes.
smoking- It’s well known that smoking increases the risk of lung cancer, but few people know that it also increases the risk of heart disease and peripheral vascular disease (disease in the vessels that supply blood to the arms and legs). Smoking also raises blood pressure, which increases the risk of stroke in people who already have high blood pressure.
birth control pills-At the beginning birth control pills contained high levels of estrogen and progestin, and taking these pills increased the chances of heart disease and stroke, especially in women older than 35 who smoked. In our days the dose of hormones contained in these pills has been lowered and they are considered safe for women younger than 35, who do not smoke or have high blood pressure.
physical inactivity- people who exercise regularly have a lower risk of heart attack than people who are not active. Exercise burns calories, may lower blood pressure and helps to control cholesterol levels and diabetes. In addition to this exercise makes the arteries more flexible and strengthens the heart muscle.